NURS-01. Toxicity exposure impacts the quality of life of patients taking targeted therapeutics

Abstract Drugs targeting the mitogen-activated protein kinase (MAPK) pathway are now prescribed to treat a variety of diseases. However, their associated cutaneous toxicities are unique and not well understood often leading to extended periods of toxicity exposure. This could negatively affect the patient’s quality of life (QOL), but this measure has not been well explored. There also remains inconsistency around classification, description and grading of these toxicities. Our objectives include a literature review to highlight data showing the impact on QOL from targeted agents and alternative ways to classify and grade these toxicities. Additionally, we will discuss the results of our prospective, single-institution study at Washington University focusing on the impact of cutaneous toxicity on QOL scores of pediatric and adolescent and young adult (AYA) patients receiving MAPK inhibitors. Through the literature review, we found several studies showing that cutaneous related problems and disease can negatively impact QOL. For our study, the Children’s Dermatology Life Quality Index and Dermatology Life Quality Index were chosen to evaluate the impact on QOL from cutaneous toxicities caused by MAPK inhibitors. The higher the score, the more QOL was impaired. A paired t-test was performed to compare the QOL scores at baseline versus those 3 months later. Sixteen patients (9 males, 7 females; average age 10.5 years) were evaluable. In patients taking a MAPK inhibitor at both timepoints, the mean QOL score changed from 3.6 to 3.2 (same) with a p-value of 0.74. This was our control group, and we did not expect a change. In the patients who started a MAPK inhibitor after taking their baseline QOL evaluation, the mean QOL scores changed from 0.5 to 3.83 (worsened), p = 0.13. In conclusion, these toxicities should be both explored and further investigated in future clinical trials.